Detecting And Treating At Once
A previous City Stories article detailed what Yeh calls the next big thing: detecting and eradicating prostate cancer at the same time using the PSMA system. A specially modified positron emission tomography scan detects areas displaying a prostate-specific membrane antigen. A radioactive isotope can then immediately deliver a cancer-killing attack to those targeted cells. Yeh is also watching the progress of another PET scan detection method, this one using Axumin, an advanced diagnostic imaging agent, or radiotracer, which may pick up cancer cells missed by other methods.
Yehs enthusiasm for all of this progress is personal. Several of his relatives have succumbed to cancer. He entered radiation oncology to find nonsurgical ways to make a difference.
Every patient, he says, is like a family member to me.
It certainly felt that way to Oakley who, after a course of radiation treatments, went into remission and has remained cancer free. Along the way, hes also made changes to his diet and exercise regimens. Hes dropped some 140 pounds, enabling him to bring renewed energy and passion to the production company he runs with his wife, Melanie Grunder.
If youre lucky enough to get to City of Hope, you are truly lucky, he said. They are the reason Im alive. Dr. Yeh took a guy not destined to be around and made him a person with purpose.
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What Is Intermittent Adt
Researchers have investigated whether a technique called intermittent androgen deprivation can delay the development of hormone resistance. With intermittent androgen deprivation, hormone therapy is given in cycles with breaks between drug administrations, rather than continuously. An additional potential benefit of this approach is that the temporary break from the side effects of hormone therapy may improve a mans quality of life.
Randomized clinical trials have shown similar overall survival with continuous ADT or intermittent ADT among men with metastatic or recurrent prostate cancer, with a reduction in some side effects for intermittent ADT .
Possible Side Effects Of Ebrt
Some of the side effects from EBRT are the same as those from surgery, while others are different.
Bowel problems: Radiation can irritate the rectum and cause a condition called radiation proctitis. This can lead to diarrhea, sometimes with blood in the stool, and rectal leakage. Most of these problems go away over time, but in rare cases normal bowel function does not return. To help lessen bowel problems, you may be told to follow a special diet during radiation therapy to help limit bowel movement during treatment. Sometimes a balloon-like device or gel is put between the rectum and the prostate before treatment to act like a spacer to lessen the amount of radiation that reaches the rectum.
Urinary problems: Radiation can irritate the bladder and lead to a condition called radiation cystitis. You might need to urinate more often, have a burning sensation while you urinate, and/or find blood in your urine. Urinary problems usually improve over time, but in some men they never go away.
Some men develop urinary incontinence after treatment, which means they cant control their urine or have leakage or dribbling. As described in the surgery section, there are different levels and types of incontinence. Overall, this side effect occurs less often with radiation therapy than after surgery. The risk is low at first, but it goes up each year for several years after treatment.
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Possible Side Effects Of Radiation Therapy
Side effects of radiation depend on the dose given and the area being treated. They tend to be worse when chemo is given along with radiation. They can include:
- Skin changes in areas getting radiation, ranging from redness to blistering and peeling
- Nausea and vomiting
- Bladder symptoms, like burning or pain when you urinate, feeling the need to go often, or blood in your urine
- Blood in stool and/or urine
- Low blood counts, which can lead to fatigue, easy bruising or bleeding, or increased risk of infection
These effects usually go away over time after treatment, but some people can have longer-term problems. For instance:
- In some people radiation treatments can lead to incontinence later on.
- Radiation can damage the lining of the bladder. This is called radiation cystitis and can cause long-term problems such as blood in the urine or painful urination.
- Nearby nerves and blood vessels might be damaged, leading to erection problems in men.
If you have side effects from radiation therapy, talk to with your health care team. They can suggest ways to ease many of them.
Low Dose Rate Brachytherapy Implants
The most common form of brachytherapy for prostate cancer, LDR involves surgically placing small radioactive pellets, about the size of a grain of rice, within the prostate. Once put in place, they remain there for life, but the radiation weakens over weeks or months, until it almost completely goes away.
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Radiation Exposure To The Bladder Results In A Transient Bladder Voiding Defect
Mice tolerated radiation treatment well as no change in body weight and behavior was detected compared to non-irradiated littermates . To assess the effect of radiation treatment on bladder function, mice were subjected to weekly micturition measurements. A significant increase in voiding frequency was observed in the mice that received radiation treatment between 4 and 8 weeks post-irradiation . Similarly, a significant decrease in the average volume per void was detected at 7 and 8 weeks after irradiation while the total voided volume remained unchanged. There was no difference in bladder function, as measured by micturition frequency and average void volume, between irradiated and control mice at 12 weeks post irradiation exposure.
Increased frequency and reduced void volume due to irradiation exposure. The average number of voids, the average volume per void, and the total voided volume were plotted for untreated and irradiated treatment groups from baseline to 12 weeks post-irradiation. *p< 0.05 **p< 0.01 ***p< 0.001. Error bars=SD.
Symptoms After Pelvic Radiation Therapy
Radiation therapy that includes external beam radiation, as well as brachytherapy, can cause immediate side effects as well as delayed urinary side effects.
The immediate urinary side effects of pelvic radiation therapy include pain with urination, blood in urine, frequent urination, and urge to urinate as well as urinary incontinence. In men, in particular, radiation therapy can cause difficulty urinating.
In men, enlarged prostate symptoms after radiation therapy can cause urinary problems.
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How To Help A Sore Throat
What you can do to help. Drink plenty of fluids at least 6 to 8 glasses each day. Dont cut down on your fluids. You can drink plenty during the day, but it might help to limit fluids 2 hours before bedtime. Some people think that cranberry juice can help but others feel it makes the soreness worse.
Leaking Urine After Surgery To Remove The Prostate Gland
Surgery to remove the prostate gland is called radical prostatectomy. Around 70 out of 100 men have problems controlling their bladder 6 months after a radical prostatectomy.
When you wake up from your operation you have a tube into your bladder to drain urine. This is a urinary catheter. You have this in place for a couple of weeks and then you go back to hospital to have the catheter removed.
You’re likely to have some urine leakage when the catheter is taken out. Its a good idea to have a supply of incontinence pads at home and to take a couple with you to hospital. You can buy these at supermarkets and pharmacies.
Its hard to say how long it will take for you to get back your bladder control. This varies between men and depends on:
- the type of surgery you had
- whether you had any problems before or during your operation
Most people get better within 3 to 6 months of their operation. But for some, it takes 1 or 2 years. A small number of men might have permanent urinary problems.
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How Does Radiotherapy Treatment Work
Radiation therapy works by use of high doses of radiation to kill or slow down its growth rate. In prostate cancer treatment it is used to kill the cancerous cells or slow the growth rate. It also kills the nearby healthy cells as it kills the cancerous cells.
Where curing the cancer is impossible, radiotherapy is used to reduce the symptoms such as pain caused by cancer tumor. It can also be used to prevent the problems that result from cancer tumor such as loss of bowel and bladder control, blindness etc.
*All individuals are unique. Your results can and will vary.
Here are different types of radiations and how they work:
What Can Help With Leaking Urine
There are treatments and products available that can help, and there are things you can do to help yourself. Your treatment options will depend on how much urine youre leaking, and how recently you had your prostate cancer treatment.
Treatments and products available that can help include:
- absorbent pads and pants
- bed protectors and handheld urinals
If you have sudden urges to urinate and sometimes leak urine before you get to the toilet , you may be offered bladder retraining.
If you still leak urine six to twelve months after surgery and pelvic floor muscle exercises havent helped, there are treatments available that might help. These may include:
- an internal male sling
- adjustable balloons
Talk to your doctor or nurse about treatments and products that may be suitable for you.
Absorbent pads and pants
These can be worn inside your underwear or instead of underwear to soak up any leaks. Some people find it helpful to wear close fitting underwear with pads. You may want to try female pads as your leaking improves, as these tend to be smaller and lighter and may fit better. Pads are usually very discreet, so people wont know youre wearing them. But you may feel more confident wearing dark trousers so it wont show as much if your pad does leak.
Pelvic floor muscle exercises
Bed protectors and handheld urinals
Internal male sling
Like all treatments, there can be side effects.
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What Is The Survival Rate Of Bladder Cancer
The general 5-year survival rate for people with bladder cancer is 77%. However, survival rates depend on many factors, including the type and stage of bladder cancer that is diagnosed. The 5-year survival rate of people with bladder cancer that has not spread beyond the inner layer of the bladder wall is 96%.
Can You Get Another Prostate Cancer
Unfortunately, being treated for prostate cancer doesnt mean you cant get another cancer. Men who have had prostate cancer can still get the same types of cancers that other men get. In fact, they might be at higher risk for certain types of cancer. Men who have had prostate cancer can get any type of second cancer,
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Frequency Of Urinary Problems After Radiation Therapy
Radiation therapy can be delivered using different methods, including external radiation therapy and brachytherapy.
Here is a list that shows the percentage of patients that experience urinary symptoms after radiation therapy for various pelvic cancers :
- Prostate Cancer: Low-grade adverse effects in 20-40 percent of patients, high-grade adverse effects in 5-13 percent of patients.
- Bladder Cancer: Low-grade adverse effects in 18-27 percent of patients, high-grade adverse effects in 6-17 percent of patients.
- Cervical Cancer: Low-grade adverse effects in 28 percent of patients, high-grade adverse effects in 8-14 percent of patients.
- Radiation effects are less common, but data is not available.
- Ovarian and Endometrial Cancers: Urinary symptoms are less common following radiation therapy for endometrial cancers, but this has not been well studied.
What Are The Dangers Of Radiotherapy Prostate Cancer Treatment
Radiotherapy is considered effective for treatment of cancer with a success rate of above 90%. But is it safe for prostate cancer treatment? Does it cause any side effects? And if yes, are radiation therapy side effects reversible?
Well, radio frequency is pain-free and considered safe for prostate cancer treatment. To help you understand the safety of this procedure we shall look at both the short and long-term side effects resulting from this treatment.
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Treatment Options For Men With Urinary Symptoms After Radiation For Prostate Cancer
Many men benefit from medical treatment to help them with urinary symptoms during IMRT, CyberKnife, proton beam, or brachytherapy. These medications include alpha-blockers such as Flomax, alpha-reductase inhibitors such as finasteride or Proscar, and anticholinergic medications such as Detrol, or Vesicare.
When medical treatment does not provide sufficient benefit or of the symptoms persist, other treatment options offered at New York Urology Specialists include Urolift procedure, Rezum procedure, iTind for prostate, Greenlight laser of the prostate, Botox injections in the bladder, and TURP.
It should be noted that men with urinary symptoms after radiation therapy for prostate cancer should have a cystoscopy at a minimum to exclude urethral stricture disease and bladder tumors. Some men may also benefit from a urodynamic evaluation.
Did you know?Dr. Shteynshlyuger has performed over 1,000 surgeries and procedures for enlarged prostate, including Rezum, Urolift, prostate enucleation, laser ablation of the prostate, and TURP. He performs over 100 prostate procedures a year.
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What To Do About Changes When You Urinate
Narrator:What to do about changes when you urinate caused by radiation therapy.
Having problems when you urinate? Listen to solutions from other people undergoing radiation therapy. Also, hear advice from Dr. Ross. Then talk with your own doctor or nurse to learn more.
Miguel:Tip number 1: Drink lots of liquids each day.It’s good for your urine to be clear or a pale yellow color. My doctor says that tells you you’re getting enough liquids. Most people find drinking about 8 cups of liquid a day does the trick. Of course, check to make sure that’s the best amount for you, too.
Cara:Tip number 2: Water is wonderful, but you may want more zip in your sip.I like water, but found it was hard to get enough water each day. I was glad to learn that Jell-O and soups also count as liquids. To add some zip to what I drink, I have water with a little lemon and watered-down juices.
Rodney:Tip number 3: Lose the booze.My doctor told me that wine, liquor, or even beer could really bother my bladder. So now I limit these liquids. Some people may need to stay away from wine, liquor, and beer altogether to avoid irritating their bladder.
My doctor also told me to stay away from caffeine in coffee, colas, or teas. They could make my bladder problems worse. I now choose flavored decaf coffees and tasty herbal teas.
Dr. Ross:Hi, I’m Dr. Ross and you just heard 3 great tips to keep bladder problems under control.
- January 23, 2020
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When Is Brachytherapy Alone The Right Choice
For some patients with disease that is confined to the prostate and not too aggressive , brachytherapy alone is a good option. It is also convenient for the patient as it is done in an outpatient setting and most people can get back to work within a few days.
But brachytherapy is not right for everyone. For some patients with less-aggressive disease, a watch-and-wait approach would be preferred. At MSK, our philosophy is that when the disease is caught very early, it is very appropriate to do active surveillance and hold off on treatment.
This philosophy applies to patients with a low PSA level, or nonaggressive disease as reflected by a Gleason score of 6 with evidence of cancer in only a few of the biopsy samples and no evidence from the MRI of a significant amount of disease. There are also very select patients with Gleason 7 disease who may be candidates for active surveillance.
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Bowel And Bladder Problems
Treatments for prostate cancer such as surgery, external radiotherapy and brachytherapy may cause damage or inflammation to organs near the prostate such as the bowels and the bladder. Men we interviewed described episodes of bleeding from the back passage, diarrhoea, constipation and damage to the bowel after radiotherapy.
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Swelling Bruising Or Tenderness Of The Scrotum
Symptoms generally resolve on their own within three to five days. Oral anti-inflammatory medications such as ibuprofen are usually sufficient for pain relief, if necessary. You should avoid hot tubs and Jacuzzis for at least two to three days after the procedure. Postpone bike riding until the tenderness is gone.
How Fast Does Prostate Cancer Spread To The Bones
Early detection can catch prostate cancer even before there are any symptoms. Some types of prostate cancer grow very slowly.
There are four main stages of prostate cancer. Within each stage, the cancer is graded based on factors like the size of tumor, prostate-specific antigen level, and other clinical signs.
If the cancer has spread to the bones, its considered to be the most advanced, or stage 4.
Newer lab tests look at the genes inside cancer cells. This can provide more information on how quickly the prostate cancer may progress.
Theres also a grading system known as the Gleason system, which assigns the cancer into a grade group based on how closely it resembles normal tissue.
During the biopsy to diagnose prostate cancer, the cells are closely examined. The more abnormal cells that are in the biopsy sample, the higher the Gleason score and grade group.
When more abnormal cells are present, the cancer is more likely to spread quickly.
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